PHILLIP KRULISKY

GRASS VALLEY, CA
NPI1073214532
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  R1500000323)
Enumeration Date2023-03-13
Last Update Date2023-03-13
Business Address
PHILLIP KRULISKY RADT
159 BRENTWOOD DR
GRASS VALLEY, CA 95945-5703
Phone number: 530-878-5166
Mailing Address
PHILLIP KRULISKY RADT
PO BOX 6021
AUBURN, CA 95604-6021
Phone number: 530-878-5166